外科老年住院患者衰弱状态与营养风险的相关性以及对结局的影响  

The association of frailty status with nutritional risk and the effect on outcomes in elderly surgical inpatients

作　　者：丁丽丽[1] 王丽娟[1] 陈丽如[1] 程博[1] 刘承宇 朱明炜[1,2] Ding Lili;Wang Lijuan;Chen Liru;Cheng Bo;Liu Chengyu;Zhu Mingwei(Department of Clinical Nutrition,Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,P.R.China,Beijing 100730,China;Department of General Surgery,Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,P.R.China,Beijing 100730,China)

机构地区：[1]北京医院临床营养科国家老年医学,中心中国医学科学院老年医学研究院,100730 [2]北京医院普通外科,国家老年医学中心,中国医学科学院老年医学研究院,100730

出　　处：《中华临床营养杂志》2023年第2期82-86,94,共6页Chinese Journal of Clinical Nutrition

基　　金：中国食品科学技术学会食品科技基金(2020-14);中国医学科学院医学与健康科技创新工程项目(2021-I2M-C&T-B-094)。

摘　　要：目的:研究衰弱状态与营养风险的关系,及其对外科老年住院患者临床结局的影响。方法:选择2021年1至6月北京医院外科老年住院患者487例为研究对象,应用衰弱筛查5项评分量表【包括疲劳感(fatigue)、阻力感(resistance)、自由活动力下降(ambulation)、多种疾病共存(illness)、体重减轻(loss of weight),简称FRAIL量表】及营养风险筛查2002(nutritional risk screening 2002,NRS 2002)进行衰弱评估及营养风险筛查,分析衰弱与营养风险关系对外科老年住院患者的影响。结果:487例外科老年患者中,无衰弱131例、衰弱前期279例、衰弱77例;有营养风险146例,其中有营养风险在无衰弱中占6.1%(8/131),衰弱前期中占31.2%(87/279),衰弱中占66.2%(51/77)。在外科老年患者衰弱的单/多因素Logistic回归分析结果中,NRS 2002评分高、年龄增长、多病共存(≥5种)等因素与衰弱相关,差异有统计学意义(P<0.001)。NRS 2002评分与FRAIL量表得分具有正相关性(r=0.448,P<0.01)。将487例患者根据FRAIL量表分为3组,通过组间多重比较得出,衰弱状态对外科老年患者住院时间及费用的影响差异均有统计学意义(均为P<0.05)。结论:衰弱在外科老年患者中发生率较高,随着衰弱的进展,营养风险发生率亦增高,二者具有相关性。衰弱可导致外科老年患者住院时间的延长及住院费用的增加。Objective To study the association of frailty status with nutritional risk and the effect on clinical outcomes among elderly surgical inpatients.Methods Elderly inpatients from the surgery department of Beijing Hospital were enrolled from January to June 2021.Frail scale and nutritional risk screening 2002(NRS 2002)were used for frailty evaluation and nutrition risk screening.The influence of frailty and associated nutrition risk in elderly surgical inpatients was analyzed.Results 487 elderly surgical patients were included,of whom 131 cases were in the non-frailty group,279 cases were in the pre-frailty group and 77 cases were in the frailty group,according to the Frail scale score.146 cases were at nutritional risk,of whom 8(6.1%of 131)were in the non-frailty group,87(31.2%of 279)in the pre-frailty group and 51(66.2%of 77)were in the frailty group.According to univariate/multivariate logistic regression analysis of frailty in elderly surgical patients,a higher NRS 2002 score,older age,and the presence of multiple concurrent diseases(≥5)were significantly associated with frailty(P<0.001).The Frail scale score was positively correlated with NRS 2002 score(r=0.448,P<0.01).Multiple comparisons showed that frailty had statistically significant effects on hospital stay and medical costs in elderly surgical patients(P<0.05).Conclusions The prevalence of frailty is higher in elderly surgical patients,and the prevalence of nutritional risk increases with the progression of frailty.Frailty can lead to prolonged hospital stays and increased hospital costs in elderly surgical patients.

关 键 词：外科老年住院患者 营养风险 衰弱 住院时间 住院费用 

分 类 号：R459.3[医药卫生—治疗学]